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Models for Developing Trauma-Informed …

Models for Developing Trauma-Informed behavioral health Systems and trauma -Specific Services 2004 Prepared by: Ann Jennings, Prepared for: National Technical Assistance Center for State Mental health Planning (NTAC), National Association of State Mental health Program Directors (NASMHPD) Under contract with the Center for Mental health Services (DMHS), Substance abuse and Mental health Services Administration (SAMHSA), Department of health and Human Services (HHS) This report was produced by the National Association of State Mental health Program Directors (NASMHPD) and the National Technical Assistance Center for State Mental health Planning (NTAC)

Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services 5 Introduction This report identifies criteria for building a trauma-informed mental health service

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1 Models for Developing Trauma-Informed behavioral health Systems and trauma -Specific Services 2004 Prepared by: Ann Jennings, Prepared for: National Technical Assistance Center for State Mental health Planning (NTAC), National Association of State Mental health Program Directors (NASMHPD) Under contract with the Center for Mental health Services (DMHS), Substance abuse and Mental health Services Administration (SAMHSA), Department of health and Human Services (HHS) This report was produced by the National Association of State Mental health Program Directors (NASMHPD) and the National Technical Assistance Center for State Mental health Planning (NTAC)

2 And is supported under a Contract between the Division of State and Community Systems Development, Center for Mental health Services (CMHS), Substance Abuse and Mental health Services Administration (SAMHSA), and the National Association of State Mental health Program Directors. Its content is solely the responsibility of the author(s) and does not necessarily represent the position of SAMHSA or its centers. Models for Developing Trauma-Informed behavioral health Systems and trauma -Specific Services 2 Table of Contents 3 5 Who Are the Models Designed For? .. 5 What Kinds of trauma are Experienced by Persons Who Develop Serious and Persistent Mental Illness and Addiction?

3 6 What Percentages of Mental health Clients Have Histories of trauma ? .. 6 Evolution of Trauma-Informed and trauma -Specific Services in State Mental health Systems .. 8 Factors Contributing to the Growth of Awareness and Activity in State Mental health Service 9 Trauma-Informed and trauma -Specific Models .. 15 Definitions of Trauma-Informed and trauma -Specific .. 15 Models for Developing Trauma-Informed Service Systems and 17 Individual Trauma-Informed Service Models .. 22 trauma -Specific Service Models for Adults:.. 24 Manualized Adaptations to trauma -Specific Service Models for 40 trauma -Specific Models for Parenting.

4 42 trauma -Specific Service Models for 47 trauma -Specific Peer Support and Self Help 54 Recommendations for Moving Forward .. 59 Appendix: Criteria for building a Trauma-Informed Mental health Service 65 70 Models for Developing Trauma-Informed behavioral health Systems and trauma -Specific Services 3 Acknowledgments The National Technical Assistance Center for State Mental health Planning (NTAC) and the National Association of State Mental health Program Directors (NASMHPD) gratefully acknowledge the many individuals and organizations that contributed to the development of this report. In particular, we would like to thank Charles Curie, , , Administrator of the Substance Abuse and Mental health Services Administration (SAMHSA), and A.

5 Kathryn Power, , Gail P. Hutchings, , Joyce T. Berry, , , and Susan E. Salasin of the Center for Mental health Services (CMHS) within SAMHSA for their time and effort and for continuing to demonstrate their commitment to this issue. Among the many individuals who contributed resources and time to this report, we would like to especially thank those dedicated and talented people who created the Trauma-Informed and trauma -specific service Models and treatment approaches presently in use within state mental health and substance abuse service systems. They patiently and carefully reviewed and revised our descriptions of their Models , clarifying those aspects of each model with relevance to state mental health and substance abuse settings, indicating the status of research and evaluative findings and identifying the specific women, men and children and parents for whom each individual approach was designed.

6 The names of and contact information for each of these individuals is included after the description of each model . Their commitment and continuing work in the field of trauma , especially with regard to the creation and research of Models which are applicable to public mental health and substance abuse settings and address the complex deeply rooted kinds of childhood abuse trauma experienced by so many recipients of public mental health and addition services, has been essential to moving the field forward towards achieving the vision of recovery and transformation portrayed in the Presidents New Freedom Commission on Mental health Final Report.

7 We also want to recognize and express our appreciation to the National trauma Consortium, its Executive Director Andrea Blanch, its nine founding board members: Vivian Brown, , Jennie Heckman, , Nancy Van DeMark, , Roger Fallot, , Colleen Clark, , Norma Finkelstein, , Hortensia Amaro, , Rene Andersen, and Sharon Cadiz, for their contributions not only in creating some of the exemplary Models described in this report, but for their patience with and responsiveness to our continual requests for more information . Chan Noether, of Policy Research Associates was particularly helpful in defining findings of the Women, Co-occurring Disorders and Violence Study.

8 More than 30 state mental health service systems and organizations, including numerous administrators, clinicians, advocates and consumers, contributed information on where, how and with whom the Models described in this report are being used. Their activities to address the needs of persons with histories of trauma and mental health problems and the specific ways and settings in which they are utilizing the Models described in this report are described state by state in the NASMHPD Blueprint for Action: building Models for Developing Trauma-Informed behavioral health Systems and trauma -Specific Services 4 Trauma-Informed Mental health Service Systems.

9 Their participation in the State Public Systems Coalition On trauma (SPSCOT a network of state system administrators, providers, researchers and C/S/Rs who share ideas, resources and support the development of Trauma-Informed systems of care through the SPSCOT Listserve) and their responsiveness to our many phone calls and emails, made it possible for us to identify trauma treatment and support Models in use in public sector settings. The varied perspectives of members of The Women, Co-Occurring Disorders Violence Study: Research into Practice in State Mental health Systems Advisory Workgroup were particularly helpful in the preparation of this report.

10 Members include: Kevin Huckshorn, , , (Director, NASMHPD/NTAC), Andrea Blanch, (Director NTC), Chan Noether, (PRA), Oscar Morgan,( Chief Operating Officer, NMHA: National Mental health Association), Steven Karp, (Medical Director), Michele Dodge (Office on Violence Against Women, DOJ), Ruta Mazelis (Cutting Edge), Vicki Cousins (OCA of SC), Suzanne Clifford (Director, Division of MH and Addiction, IN), and Carol Shapiro (Executive Director, Family Justice, Inc). Finally, acknowledgments and thanks go to NTAC staff members who helped produce, publish and disseminate this report, including Robert Hennessy, editor and publications coordinator; Ieshia Haynie, program associate.


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